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International Research on Infant Supplementation: Randomized Controlled Trials of Micronutrient Supplementation During Infancy

Efficacy of Multiple Micronutrient Supplementation for Improving Anemia, Micronutrient Status, Growth, and Morbidity of Peruvian Infants^1,2

Post Graduate Program in Public Nutrition, Universidad La Molina, Lima, Peru and ^* Nutrition Section, Program Division, UNICEF, New York, NY

³To whom correspondence should be addressed. E-mail: gromana{at}lamolina.edu.pe.

Anemia, micronutrient deficiencies, and growth faltering are still common in Peru. The study objective was to determine the efficacy of different micronutrient supplements in preventing growth failure, anemia, and micronutrient deficiencies in Peruvian infants. Three hundred and thirteen infants aged 6 to 12 mo participated in a double-blind, masked, controlled trial in which they were randomly assigned to receive either a daily dose of iron (DI), a daily dose of multiple micronutrients (DMM), a weekly dose of multiple micronutrients, or a placebo (P) for 6 mo. None of the supplements tested prevented growth faltering or the morbidities common during infancy. Anemia and plasma homocysteine concentrations fell significantly in all groups during the study, but the mean change of plasma homocysteine during the trial period was significantly smaller in the DI group than in other groups, and the increase in hemoglobin concentrations was smaller in the P group than the micronutrient treatment groups. Plasma ferritin concentrations decreased least in the groups taking daily micronutrient supplements containing iron (DI and DMM). There were no significant differences among groups in mean final values or changes in plasma zinc, retinol, tocopherol, or riboflavin. Although the DMM intervention was the most efficacious for preventing anemia, iron, and zinc deficiencies, 15%, 20%, and 50% of this group still remained anemic, zinc deficient, and iron deficient, respectively, at the end of the study. Further research thus should investigate whether higher doses of iron and zinc, together with infection control measures, are more efficacious.

KEY WORDS: • micronutrient supplementation • iron • zinc • anemia • growth faltering • Peru • infants

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